Metabolic acidosis in patients with diabetes 2 undergoing cardiac surgery: The impact of SGLT2 inhibitor use: a retrospective cohort study.

Background: Sodium-glucose cotransporter 2 inhibitors (SGLT2-i) lower blood sugar and reduce cardiovascular events and kidney failure. However, there have been increasing reports of euglycaemic diabetic ketoacidosis (eDKA) linked to SGLT2-i medicines.

Objective: Investigating the association between SGLT2-i use and the incidence of metabolic acidosis in patients with type 2 diabetes undergoing cardiac surgery.

The importance of concomitant mitral regurgitation for estimates of mitral valve area by pressure half time in patients with chronic rheumatic heart disease.

Aims: Aim was to study how concomitant mitral regurgitation (MR) assessed by qualitative and quantitative methods influence mitral valve area (MVA) calculations by the pressure half time method (MVA) compared to reference MVA (planimetry) in patients with rheumatic heart disease.

Methods And Results: In 72 patients with chronic rheumatic heart disease, MVA was calculated as 220 divided by the pressure half time of the mitral early inflow Doppler spectrum. Direct measurement by planimetry was used as reference MVA and was mean (SD) 0.

Short-term outcome after open-heart surgery for severe chronic rheumatic heart disease in a low-income country, with comparison with an historical control group: an observational study.

Objectives: Rheumatic heart disease (RHD) is a major burden in low-income and middle-income countries (LMICs). Cardiac surgery is the only curative treatment. Little is known about patients with severe chronic RHD operated in LMICs, and challenges regarding postoperative follow-up are an important issue.

Is the use of hydroxyethyl starch as priming solution during cardiac surgery advisable? A randomized, single-center trial.

Introduction: The use of cardiopulmonary bypass (CPB) leads to increased fluid filtration and edema. The use of artificial colloids to counteract fluid extravasation during cardiac surgery is controversial. Beneficial effects on global fluid loading, leading to better cardiac performance and hemodynamics, have been claimed.

Surface cooling versus core cooling: comparative studies of microvascular fluid- and protein-shifts in a porcine model.

Objective: To describe how surface cooling compared with core cooling influences fluid and protein distribution, vascular capacity and hemodynamic variables.

Methods: 14 anesthetized piglets were, following 60 min normothermic stabilization, randomly cooled by surface cooling (ice-sludge) (n=7) or core cooling (endovascular cooling) (n=7) to about 28 degrees C. Fluid balance, hemodynamic variables, colloid osmotic pressures (plasma/interstitial fluid), hematocrit, serum-albumin and -protein concentrations, intracranial pressure (ICP) and cerebral metabolic markers of ischemia were measured.

Intraoperative fluid balance during cardiopulmonary bypass: effects of different mean arterial pressures.

Introduction: This study investigated whether two levels of mean arterial pressure (MAP) during cardiopulmonary bypass did influence per-operative fluid shifts.

Methods: Sixteen pigs underwent 60 minutes of normothermic cardiopulmonary bypass (CPB) followed by 90 minutes of hypothermic CPB. Eight animals had a MAP of 60-80mmHg by norepinephrine (HP group).

Fluid overload during cardiopulmonary bypass is effectively reduced by a continuous infusion of hypertonic saline/dextran (HSD).

Objective: Cardiopulmonary bypass (CPB) is associated with fluid overload. We examined how a continuous infusion of hypertonic saline/dextran (HSD) influenced fluid shifts during CPB.

Materials And Methods: Fourteen animals were randomized to a control-group (CT-group) or a hypertonic saline/dextran-group (HSD-group).

Low perfusion pressure during CPB may induce cerebral metabolic and ultrastructural changes.

Background: Recently we reported on cerebral metabolic changes suggesting ischemia in piglets during nitroprusside-induced low-pressure CPB. We here investigated whether a mean arterial pressure (MAP) of 40-45 mmHg could provoke similar changes by a NO-independent intervention.

Methods: Piglets underwent 60 minutes normothermic followed by 90 minutes hypothermic CPB.

Elevated flow rate during cardiopulmonary bypass is associated with fluid accumulation.

Objective: High flow rates during cardiopulmonary bypass are assumed to increase fluid accumulation. This study aimed to determine whether two different flow rates during cardiopulmonary bypass alter the intraoperative fluid balance and extravasation rate.

Methods: Sixteen pigs underwent 60 minutes of normothermic bypass, followed by 90 minutes of hypothermic bypass.

Mean arterial pressure about 40 mmHg during CPB is associated with cerebral ischemia in piglets.

Objective: To investigate if a mean arterial pressure below 50 mmHg during CPB may lead to cerebral ischemia.

Material And Methods: Piglets with low mean arterial pressure by nitroprusside (LP-group) (n=6) were compared with piglets given norepinephrine to obtain high pressure (HP-group) (n=6) during normothermic and hypothermic CPB. Intracranial pressure, flow and markers of cerebral energy metabolism (microdialysis) were recorded.

Cold-induced fluid extravasation during cardiopulmonary bypass in piglets can be counteracted by use of iso-oncotic prime.

Objective: Hypothermic cardiopulmonary bypass is associated with increased fluid extravasation. This study aimed to compare whether iso-oncotic priming solutions, in contrast to crystalloids, could reduce the cold-induced fluid extravasation during cardiopulmonary bypass in piglets.

Methods: Three groups were studied: the control group (CT group; n = 10), the albumin group (Alb group; n = 7), and the hydroxyethyl starch group (HES group; n = 7).

Time course variations of haemodynamics, plasma volume and microvascular fluid exchange following surface cooling: an experimental approach to accidental hypothermia.

Objective: To describe how surface cooling influences fluid distribution, vascular capacity and haemodynamic variables.

Methods: Seven anaesthetised pigs, following normothermic stabilization for 60 min, were cooled to 27.8+/-1.